1. Arthroscopic ankle fusion
Case for small group discussion
AOTrauma—Foot & Ankle
Module 7: Ankle arthritis
Christina Kabbash, US

2. Case description
63-year-old man with a history of rheumatoid arthritis (RA)
Active hiker, farmer
Varus hindfoot on the left
Valgus hindfoot on the right
Ankle ROM: 0o dorsiflexion; 20o plantar flexion
Normal subtalar ROM
Some neuropathy of the distal 1/3 leg
Considerations: if fuse –
ROM: range of motion

3. Preoperative x-rays

4. Preoperative planning
Considerations:
Mild deformity
Good bone stock
Poor skin envelope due to RA medications
Age and activity profile suggest not a good candidate for total ankle arthroplasty
Arthroscopic ankle fusion—decreased size of incisions, better soft-tissue healing

5. 1-year postoperative x-rays
Comments:
Fibula left intact
Well reduced

6. 1-year postoperative x-rays

7. Take-home messages Indications for arthroscopic ankle fusion:
Younger patient
Active
Mild deformity
Compromised soft tissues